<%@ page language="java" import="java.util.*" pageEncoding="utf-8"%>
<%@ taglib prefix="s" uri="/struts-tags" %>
<%
String path = request.getContextPath();
String basePath = request.getScheme()+"://"+request.getServerName()+":"+request.getServerPort()+path+"/";
%>
   
<div class="pageContent">
	<form method="post"  action="<%=basePath %>customer_alter_List.action" class="pageForm required-validate" onsubmit="return validateCallback(this, navTabAjaxDone);">
		<div class="pageFormContent" layoutH="56">
			<p>
				<label>客 户 号：</label>

				<input name="customer.customerId" type="text" size="32" value="<s:property value="#parameters.customerId"/>" readonly="readonly"/>

			</p>
			<p>
				<label>客户姓名：</label>

				<input name="customer.cname" class="required" type="text" size="32" value="<s:property value="customer.cname"/>" />

				

			</p>
			<p>
				<label>身份证号：</label>

				<input name="customer.cardId" class="required" type="text" size="32" value="<s:property value="customer.cardId"/>" />

				

			</p>
			<p>
				<label>性别：</label>

				<s:if test="customer.cgender==\"男\"">
					<select name="customer.cgender" class="required combox">
						<option value="">请选择</option>
						<option value="男" selected>男</option>
						<option value="女" >女</option>
					</select>
				</s:if>
				<s:else>
					<select name="customer.cgender" class="required combox">
						<option value="">请选择</option>
						<option value="男" >男</option>
						<option value="女" selected>女</option>
					</select>
				</s:else>
			</p>
			<p>
				<label>年龄：</label>

				<input name="customer.cage" class="digits" type="text" size="32"  maxlength="3" value="<s:property value="customer.cage"/>" onkeyup="javascript:this.value=this.value.replace(/[^\d]/g,'');
if(this.value<0){
this.value=0;};
if(this.value>200){this.value=200;}"
 onchange="javascript:this.value=this.value.replace(/[^\d]/g,'');
if(this.value<0){
this.value=0;};
if(this.value>200){this.value=200;}" /> 
				

				

			</p>
			<p>
				<label>婚姻状况：</label>
				
				<s:if test="customer.isMarried">
					<select name="customer.isMarried" class="required combox">
						<option value="">请选择</option>
						<option value="true" selected>已婚</option>
						<option value="false" >未婚</option>
					</select>
				</s:if>
				<s:else>
					<select name="customer.isMarried" class="required combox">
						<option value="">请选择</option>
						<option value="true" >已婚</option>
						<option value="false" selected>未婚</option>
					</select>
				</s:else>
			</p>
			<p>
				<label>职业：</label>

				<input type="text" size="32" name="customer.occupational" value="<s:property value="customer.occupational"/>"/>

				

			</p>
			<p>
				<label>血型：</label>
				<select name="customer.bloodGroup" class="required combox">
					<option value="">请选择</option>
					<option value="A" selected>A</option>
					<option value="B" >B</option>
					<option value="AB" >AB</option>
					<option value="O">O</option>
				</select>
			</p>
			<p>
				<label>文化程度：</label>
				<select name="customer.education" class="required combox">
					<option value="">请选择</option>
					<option value="小学">小学</option>
					<option value="初中" >初中</option>
					<option value="高中" >高中</option>
					<option value="大学及以上" selected>大学及以上</option>
				</select>
			</p>
			<p>
				<label>家庭住址：</label>

				<input type="text" name="customer.caddr"  size="32" value="<s:property value="customer.caddr"/>"/>

				

			</p>
			<p>
				<label>工作单位：</label>

				<input type="text" size="32" name="customer.company"  value="<s:property value="customer.company"/>" />

			

			</p>
			<p>
				<label>RH阴性：</label>
				<select name="customer.rhNegative" class="required combox">
					<option value="">请选择</option>
					<option value="+">+</option>
					<option value="-" selected>-</option>
				</select>
			</p>
			<p>
				<label>户籍地址：</label>

				<input type="text" size="32" name="customer.homeTown" value="<s:property value="customer.homeTown"/>" />

			

			</p>
			<p>
				<label>患者来源：</label>

				<input type="text" size="32" name="customer.fromSrc" value="<s:property value="customer.fromSrc"/>"/>

				

			</p>
			<p>
				<label>医保方式：</label>

				<input type="text" size="32"  name="customer.medicalInsurance" value="<s:property value="customer.medicalInsurance"/>"/>

				

			</p>
			<p>
				<label>患者习惯：</label>

				<input type="text" size="32"  name="customer.habits" value="<s:property value="customer.habits"/>"/>

				
			</p>
			
			<p>
				<label>残疾证号：</label>
				<input type="text" size="32" maxlength="20" name="customer.disabilityId" value="<s:property value="customer.disabilityId"/>"/>
			</p>
			<p>
				<label>是否残疾：</label>
				<s:if test="customer.isDisability">
					<select name="customer.isDisability"  class="required combox">
						<option value="">请选择</option>
						<option value="true" selected>是</option>
						<option value="false" >否</option>
					</select>
				</s:if>
				<s:else>
					<select name="customer.isDisability"  class="required combox">
						<option value="">请选择</option>
						<option value="true" >是</option>
						<option value="false" selected>否</option>
					</select>
				</s:else>
			</p>
			
		</div>
		<div class="formBar">
			<ul>
				<!--<li><a class="buttonActive" href="javascript:;"><span>保存</span></a></li>-->
				<li><div class="buttonActive"><div class="buttonContent"><button type="submit">保存</button></div></div></li>
				<li>
					<div class="button"><div class="buttonContent"><button type="button" class="close">取消</button></div></div>
				</li>
			</ul>
		</div>
	</form>
</div>       
